Wellness is a state of mind and body. It is an individual thing.

So, when it comes to employee participation, let’s not get lured into the misconception that wellness only works in large numbers, and therefore is more fitting for a sprawling Fortune 500 company than it is for a small business with 25 to 100 employees.

Wellness today is for all employers and all employees. And although today, cable TV stations today are full of exercise shows, fitness magazines clutter newsracks, and health clubs pop up on every street corner, even back in the 1980s, when I was consulting with small businesses, some of them had a wellness program in place — and didn’t even realize it.

When break time came, the employees of one particular small company would take a walk around the block. Walking together during business hours was built into this company’s culture. The only difference between then and now is, today we would count the steps with a pedometer clipped to our belt and walk while listening to an iPod rather than a Sony Walkman. But the results remain the same.

In our small office in North Carolina, we hold meetings outside, all the while tossing a baseball back and forth. When we talk on the phone with a client, it’s not while staring at a computer screen, but by taking advantage of today’s communications technology and conversing while walking around our office holding 2.5- or 5-pound weights, and we may even take that conversation outside.

But when it comes to getting a company to implement a wellness program into its corporate culture, it all comes down to getting employees to practice what you preach. What I’ve found to be effective in this respect is utilizing the old “KISS” system — with a slight modification: Keep It Simple Sells.

This is not to suggest that a good agent doesn’t know that having a solid health and wellness plan in place will benefit their client. But sometimes the litany of objections from the employers — “There’s nothing I can do about health-care costs going up,” or “It’s too expensive,” or “We don’t have the facilities for exercise,” or “My employees won’t want to do it” — can sometimes be overwhelming.

Randy and Dustin Boss of Ottawa Kent in Jenison, Mich., have spent four years testing and creating a trademarked process, “Bringing Risk Management to Benefits,” so that when risk management and benefits gently collide, the CEO understands the aggregate health risks in his or her employee population. They can then take steps to promote changing the detrimental risk factors that lead to disease and high cost. The ultimate wellness destination is keeping healthy people healthy while improving the health of the less healthy.

 “Employers are frustrated because most likely they have tried things that didn’t work,” says Randy Boss. “They tend to think short term and not long term, and want to see solid and immediate benchmarks.”

The goal is to make the employer view wellness as an investment, not an expense. And it’s a mission not to be taken lightly as employers see rising health costs and, in many cases, aging workers.

John Basten of The Mid-State Group in Lynchburg, Va., says employers are frustrated with the ever-increasing cost of health premiums, and thus turn to brokers for solutions, which often include delivering “wellness” by implementing disincentives and benefit design changes in an effort to change behavior. That’s a concept that Basten says doesn’t work.

 “It’s only through education that you can guide employers to better understand the risks and obstacles they are facing,” he explains. “Essentially, Step One is to help them identify the specific health factors within their company, because when real data drives the decision, one can plan for the expected results.”

York International, a large regional broker in Harrison, N.Y., derives about 25% of its $10 million in revenue from benefits serving the middle-market employer of 50-2,500 employees. For the past five years, York has been focusing on wellness or risk management within a health sphere from an employee benefit standpoint that really came out of a continual effort to be able to draw resources and capabilities from much larger entities and bring them to smaller entities.

“The Fortune 1000 or 5000 have been practicing engaging employees in health beyond the financing of sickness for many years, and we think that there is a tremendous opportunity to continue to do that with these middle-market companies,” explains Mike Bodack of York International. “When our point of entry is who we call the ‘user buyer' of insurance for their company, we try to engage the ‘economic buyer’ as well.  It is not often the same person, but it does happen on occasion.”

“When we deal with that economic buyer, we find that it is easy to focus the conversation,” Bodack adds. “Certainly, some folks will have their head in the sand. But the ones who are intelligent, rational human beings understand very quickly.  Because in the end, it’s just a math problem.”

When employers perceive wellness as an added cost instead of an added benefit, bad things happen. Or nothing happens at all. Basten has fought that battle for years.

 “Employers are frustrated with the ever-increasing cost of health care and are looking for viable strategies to reverse the trend,” he says. “Many are looking for quick fixes which end in employers spending excessive funds in areas that don’t have long-lasting effects. Our specific focus is to educate the employer on how wellness should be defined as an employee benefit.”

Getting the employees behind a wellness program can often be the fuel that jump-starts an employer’s decision-making process, as the perception of it as a potential expense reverses into a benefit, reaping potential dividends in terms of an increase in employee morale and a decrease in the number of days out of work due to a workplace injury and/or illness.Often, Bodack sees it coming down to an employee kickoff.

“We’ve received tremendous response from our kickoff meetings,” says Mike. “The delivery of the health risk assessment to an employee is a measure of control all by itself. When an employee takes the 10 minutes to read it, it may be more information than they get about their health from their own doctor. And, an annual health risk assessment offers the employee a grand picture of his or her health, year after year.”

Bodack goes on to say that, when employees have something personalized, such as their assessment, and see directives they can look at year after year, it provides a tremendous level of control and a heightened awareness.

“We routinely reach 85 or 90% involvement from employees who review their Health Risk Assessments,” he adds.

Wellness experts agree that employers should not rely on incentives for employee involvement in the program. And, conversely, neither should they be penalized for not participating.

“Employees are already struggling with family pressures and an uncertainty about the future,” says Basten. “The last thing employees need is a work environment where they are told what not to do and being penalized for doing so. This doesn’t create a thriving corporate culture. Wellness should be offered solely as a benefit and not as a ‘reward,’ and delivered to the employees as such. Only then will the employer get the proper participation they need for the program to be successful.”

Mark Nantz of Knapp Miller Brown Insurance Services in Salem, Ind., says a key component of a successful wellness program is the shared-clinic model, a benefit that also includes wellness coaches.

“The shared-clinic model allows smaller employers to use the clinic model, as long as there is a larger employer to act as the anchor,” says Nantz. “Think of a shopping center with the large big-box store as the anchor tenant. A large employer can have its own clinic, and it can act as an anchor for surrounding companies to share its on-site clinic.  On-site clinics can also pull out employees with chronic illnesses and focus on wellness initiatives for those folks.”

It has become increasingly clear that workers’ compensation, employee benefits, and wellness are the three faces of employee health, and the cost of that health means insurance producers must be equipped to bring a unified approach to employers. With the new health-care reform, employers will have an enormous need for expert advice on benefits and wellness. Health-care agents of the future are quickly arming themselves with new ways to attack the true root causes that are driving up health-care costs.  And if employers can make their employees healthier without cutting benefits or shifting more premium costs to their employees, where is the down side?